What question did this study set out to answer?

To investigate the impact of posttransplant opioid dependence on pancreas transplantation outcomes and graft survival.

January 16, 2026Clinical Transplantation0 citations

Opioid Use as a Predictor of Pancreas Transplant Outcomes

YKYoungmin KoAsan Medical Center ECEunbyeol ChoKorea Advanced Institute of Science and Technology HKHye Eun Kwon

Key Points

To investigate the impact of posttransplant opioid dependence on pancreas transplantation outcomes and graft survival.
Analyzed data from 193 pancreas transplant recipients from Asan Medical Center and 77 recipients from Pusan National University Yangsan Hospital.
Defined opioid dependence as receiving ≥ 10 opioid prescriptions 3 to 12 months posttransplant.
Used logistic regression and machine learning algorithms (CatBoost, XGBoost, LightGBM) for risk factor analysis and predictions.
Posttransplant opioid dependence was an independent predictor of 5-year graft failure (OR 2.87, p = 0.005).
Other significant predictors included pre-transplant retinopathy, bladder drainage, and lower BMI.
Machine learning models demonstrated favorable internal AUROC (0.695–0.719) and moderate external AUROC (0.649–0.671) for predicting graft survival.

Abstract

ABSTRACT Background Posttransplant opioid dependence has been linked to adverse outcomes in solid organ transplantation, but its impact on pancreas transplantation is underexplored. Methods This retrospective study analyzed 193 PTA/PAK recipients from Asan Medical Center (AMC) (2010–2022) and externally validated results in 77 recipients from Pusan National University Yangsan Hospital (PNUYH) (2015–2022). Posttransplant opioid dependence was defined as ≥ 10 opioid prescriptions between 3 and 12 months posttransplant. Logistic regression and three ML algorithms (CatBoost, XGBoost, and LightGBM) were used to identify risk factors and predict 5‐year graft survival. Results Posttransplant opioid dependence (OR 2.87, p = 0.005) independently predicted 5‐year graft failure, along with pre‐transplant retinopathy, bladder drainage, and lower BMI. ML models showed favorable internal AUROC (0.695–0.719) and moderate external AUROC (0.649–0.671). Opioid dependence consistently ranked among top predictive features across models. Conclusions Posttransplant opioid dependence is a significant predictor of graft failure after pancreas transplantation. Incorporating this variable into ML models may enhance risk stratification and candidate selection.

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Cite This Study

Ko et al. (Thu,) studied this question.

synapsesocial.com/papers/6969d4a2940543b9777098a1 https://doi.org/https://doi.org/10.1111/ctr.70453

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